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NPI Code Detail

MEDICARE: LAY'C KATHLEEN YOUNG FNP-C

MEDICARE: LAY'C KATHLEEN YOUNG FNP-C
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LF0000XFamily Nurse PractitionerAP141594TX

General Provider Information

NPI Number : 1942856562
Entity Type Code : Individual
Provider Name (Legal Business Name) : LAY'C KATHLEEN YOUNG FNP-C
Provider Business Mailing Address
First Line : 3602 TRYON RD
Second Line :
City : LONGVIEW
State : TX
Zip : 75605-8311
Country : US
Telephone Number : 430-200-4350
Fax Number : 833-491-2722
Provider Business Practice Location Address
First Line : 515 N 3RD ST STE A
Second Line :
City : LONGVIEW
State : TX
Zip : 75601-6546
Country : US
Telephone Number : 903-475-2713
Fax Number : 903-942-2930
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/12/2019
Last Update Date : 10/03/2023

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Directions to “ LAY'C KATHLEEN YOUNG FNP-C” Practice Location

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